March 10th, 2014
As a resident physician in my final year of Radiation Oncology training in the UC San Diego Health my department has kindly sponsored me to do a visiting training rotation internationally. The Department of Radiation Oncology at the Chulalongkorn Memorial Hospital in Bangkok, Thailand graciously agreed to let me visit for one month to gain new perspectives and learn from their wealth of experience. UC San Diego and Chulalongkorn Hospital have ongoing research collaborations and have formed an educational bond in recent years.
On my first day in the Radiation Oncology Department at Chulalongkorn Hospital I was greeted warmly by the staff and resident physicians. Their department is a cutting-edge technological center with a highly-experienced faculty. Their clinic has an MRI simulation scanner for treatment planning, a sophisticated gynecologic cancer brachytherapy (internal radiation) program, and arc delivery of intensity-modulated radiotherapy (which allows for efficient delivery of shaped x-ray doses). I was impressed when I learned that radiation oncologists in Thailand also routinely administer chemotherapy, which is an extremely complex practice that radiation oncologists in the USA almost never perform.
In the coming weeks I expect that I will be able to learn greatly from the experience of the staff at Chulalongkorn Hospital and from working in the healthcare system of Thailand. Likewise I hope to be able to share some of the knowledge and philosophies that I have gained during my Radiation Oncology training at UC San Diego.
March 17th, 2014
In my first week working at Chulalongkorn Hospital I was interested to learn about differences in cancer epidemiology in Thailand as compared to the USA. In Thailand prostate cancer screening and treatment are less common than in the USA. On the other hand, nasopharynx cancer (a head and neck cancer) and cholangiocarcinoma (bile duct cancer) are extremely common in Thailand. The prevalence of Cholangiocarcinoma is increased in Thailand due to exposure to the endemic liver fluke. Given how common these types of cancer are in Thailand the radiation oncologists at Chulalongkorn Hospital are very skilled at treating these challenging diseases and I was able to learn a great deal on these subjects. Throughout my rotation I also had the opportunity to give some educational presentations to the staff and residents sharing some of our philosophies on treatment of cervical cancer, salivary gland cancer, and early-stage lung cancer. Being able to exchange ideas is the essence of a visiting rotation and I felt as though we made the most of this opportunity.
March 24th, 2014
I was so grateful for how friendly and gracious the faculty and residents at Chulalongkorn hospital were during my rotation, and the same is true of all the Thai people I met during my stay. History, architecture, and food are wonderful aspects of Thai culture that I enjoyed, but I also appreciated many of the cultural values I observed during interactions between physicians and patients, as well as between staff members. The respect that people have for one another and for the opinions of others is an indispensable value in Thai culture, which I admired. I will try to remember this point the next time there is a heated debate during a tumor board conference!
March 31st, 2014
It was hard to say goodbye during my final week at Chulalongkorn Hospital because I knew how much I would miss the staff and residents. I gained many valuable philosophies and techniques during my rotation, which I will carry with me during my career. On my last day in Bangkok I wanted to leave a memento from San Diego, so I gave the staff a framed baseball jersey to keep in the resident room.
Certain principles are universal among radiation oncologists throughout the world, such as the desire to continually gain new information that we can use to take better care of our future patients.